Radiation therapy is a form of treatment for bladder cancer. It’s primarily used for those who can’t have or choose not to have surgery. Radiation therapy is more effective when given with chemotherapy.

Radiation therapy (RT) is one of the most common types of cancer treatment. You may also see RT called “radiotherapy.”

RT works to treat cancer by using high-energy waves or particles to damage the DNA inside cancer cells. The therapy interferes with the ability of cancer cells to grow and divide, leading to their death.

If your condition has been diagnosed as bladder cancer, it’s possible that RT may be a part of your treatment plan. Below, we’ll explore how RT is used to treat bladder cancer, what to expect, and more.

Generally speaking, surgery is the standard treatment for muscle-invasive bladder cancer.

Surgery typically involves a radical cystectomy, which is the complete removal of the bladder, but RT can also be used as the main treatment for bladder cancer.

RT may be used if you aren’t eligible for or choose not to have surgery. Some examples of times when surgery may not be recommended are if you:

  • are at an older age
  • have other significant underlying medical conditions
  • have cancer that can’t be removed with surgery

A 2019 study of 7,461 people with muscle-invasive bladder cancer found that 75% of participants had a radical cystectomy, while the remaining 25% received RT.

Radiation with surgery and chemotherapy

When RT is given with curative intent, it’s called “radical radiotherapy.” This treatment is often used along with other bladder cancer treatments that focus on treating your cancer while preserving your bladder, such as transurethral resection (TUR) or chemotherapy.

TUR is a type of surgery that removes the cancer but not the entire bladder. Chemotherapy is a treatment that uses drugs to kill cancer cells or slow cancer cell growth.

Radiation with chemotherapy

When RT is given with chemotherapy, it’s called “chemoradiation.” The addition of chemotherapy helps the radiation to work better.

Other situations in which RT may be used for bladder cancer are:

Can bladder cancer be cured with radiation therapy?

It’s unlikely that RT alone will eliminate your cancer. RT is often more effective when given with other bladder cancer treatments. For example, a study from 2019 and research presented in 2023 have shown that radical radiotherapy with chemotherapy is more effective than RT alone.

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RT for bladder cancer is given using external beam radiation. In this type of RT, a machine delivers the radiation from outside of your body.

Before receiving RT, you’ll have a planning session with a medical care team called a “simulation.” During this time, the team will:

  • map where the cancer is in your body, typically by using imaging such as a CT scan or an MRI scan
  • find the right angles at which to direct the radiation
  • decide the dose of radiation you’ll receive, which includes the total dose and the dose per treatment

You’ll typically receive your RT as an outpatient procedure at a hospital or cancer treatment center. Most people have external beam RT 5 days a week with a break at the weekend to let healthy cells recover. Total treatment time may be from 4 to 7 weeks.

Does radiation therapy hurt?

Receiving RT is painless. A radiation therapist will ask you to lie down on a treatment table or sit in a special chair and keep very still. They’ll then go to a nearby room to administer your RT.

It only takes a few minutes to deliver the radiation itself, but appointments can last up to 30 to 60 minutes to allow the radiation therapist to ensure that your body is in the proper position.

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RT, especially when used along with other treatment types, can be effective for bladder cancer, but the success of RT compared with radical cystectomy remains unclear.

According to the National Cancer Institute, there’s no strong evidence as to whether RT or radical cystectomy is more effective. It also notes that both types of treatment are more effective when combined with chemotherapy.

In fact, studies from 2020 and 2023 have found similar outcomes between RT and radical cystectomy. Meanwhile, there are studies from 2019 and 2022 that have found that cystectomy is linked to an improved outcome.

What’s the best type of treatment for bladder cancer?

There’s no one-size-fits-all treatment for bladder cancer. The type of treatment that you receive may depend upon many factors, including:

  • the type of bladder cancer you have
  • the stage of your bladder cancer
  • how aggressive the cancer is
  • your age and overall health
  • your personal preference
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The biggest benefit of RT is that it can be effective in the treatment of bladder cancer. RT is particularly effective when it’s used alongside other treatments.

Unlike a radical cystectomy, people who undergo RT don’t need urinary diversion surgery. RT-focused treatment allows you to preserve your bladder.

Despite its benefits, RT does have side effects that may include:

Many side effects go away after treatment. For example, a 2020 study found that people reported that their quality of life declined immediately after chemoradiation for bladder cancer but returned to baseline after 6 months.

Radiation therapy also has long-term side effects

It’s important to be aware that RT to your pelvic area can potentially lead to long-term side effects as well. Long-term side effects may include:

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In addition to RT, other interventions that may be a part of your bladder cancer treatment plan include:

  • Surgery: which can involve TUR or radical cystectomy with urinary diversion
  • Chemotherapy: which uses drugs that interfere with the growth of cancer cells
  • Intravesical therapy: in which a chemo or immunotherapy drug is injected directly into your bladder
  • Immunotherapy: a cancer treatment that boosts your immune system’s response to cancer
  • Targeted therapy: which uses drugs that are directed at specific markers on or inside of cancer cells

While many bladder cancers are treated with surgery, RT is another potential treatment option. RT can be used for people who can’t or choose not to have their bladder removed. RT is often combined with chemotherapy.

RT for bladder cancer is given using external beam radiation. The length of your treatment and the dose of radiation given will all depend on your individual situation.

While it can be beneficial for bladder cancer, RT is also linked to short- and long-term side effects. Be sure to discuss these with a doctor if RT is recommended as a part of your treatment plan.